Charak Samhita

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Yapana basti (view source)

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<p style="text-align:justify;">The word ‘yapana’ means to sustain or to maintain. The therapeutic enema (basti) intended for sustaining life is termed as ‘Yapana basti’. It is indicated in chronic and critical conditions like  urolithiasis (ashmari), insanity  (unmada), obstinate urinary diseases (prameha), abdominal distension (adhmana), vatarakta.[Cha.Sa. Siddhi Sthana 12/16] It is used for providing instant nourishment and strength. In current practices, yapana basti is mainly used in disease of shukra and asthi dhatu like infertility and lumbar spondylosis etc.. The present chapter deals with specific indications of yapana basti and its utility in current practices.</p>
+
<p style="text-align:justify;">The word ‘yapana’ means to sustain or to maintain. The [[Basti|therapeutic enema (basti)]] intended for sustaining life is termed as ‘Yapana basti’. It is indicated in chronic and critical conditions like  urolithiasis (ashmari), insanity  ([[Unmada Chikitsa|unmada]]), obstinate urinary diseases ([[Prameha Nidana|prameha]]), abdominal distension (adhmana), [[Vatarakta Chikitsa|vatarakta]].[Cha.Sa. [[Siddhi Sthana|Siddhi Sthana]] 12/16] It is used for providing instant nourishment and strength. In current practices, yapana basti is mainly used in [[Vyadhi|disease]] of [[Shukra dhatu|shukra]] and [[Asthi dhatu|asthi dhatu]] like infertility and lumbar spondylosis etc.. The present chapter deals with specific indications of yapana basti and its utility in current practices.</p>
    
{{Infobox
 
{{Infobox
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|label2 = Authors
 
|label2 = Authors
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|data2 = Kulkarni Gajanan<sup>1</sup>, <br/>Deole Y.S. <sup>2</sup> <br/>Bhatt Hemisha<sup>2</sup>
+
|data2 = Kulkarni Gajanan<sup>1</sup><br/>[[Yogesh Deole|Deole Y.S.]]<sup>2</sup><br/>Bhatt Hemisha<sup>2</sup>
    
|label3 = Reviewer & Editor
 
|label3 = Reviewer & Editor
−
|data3 = Basisht G.<sup>3</sup>
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|data3 = [[Gopal Basisht|Basisht G.]]<sup>3</sup>
    
|label4 = Affiliations
 
|label4 = Affiliations
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== Synonyms ==
 
== Synonyms ==
 
Following words are synonymous to yapana.  
 
Following words are synonymous to yapana.  
−
* Dharanam – to maintain [Su. Sa. Nidana Sthana 1/12]
+
* Dharanam – to maintain [Su. Sa. [[Nidana Sthana|Nidana Sthana]] 1/12]
−
* Poshanam – to nourish [Su. Sa. Nidana Sthana 14/30]
+
* Poshanam – to nourish [Su. Sa. [[Nidana Sthana|Nidana Sthana]] 14/30]
−
* Rog-shamanam – to pacify disease [ Su. Sa. Chikitsa Sthana 6/13]
+
* Rog-shamanam – to pacify [[Vyadhi|disease]] [Su. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 6/13]
−
* Yatrakara- supporting journey of life [ Cha. Sa. Sutra Sthana 18/39]
+
* Yatrakara- supporting journey of life [Cha. Sa. Sutra Sthana 18/39]
−
* The basti which promotes longevity of life is ‘yapana basti’ [Chakrapani on Cha. Sa. Siddhi Sthana 12/17]
+
* The basti which promotes longevity of life is ‘yapana basti’ [Chakrapani on Cha. Sa. [[Siddhi Sthana|Siddhi Sthana]] 12/17]
−
* Pranadharana-  sustain viatality [Arundatta A.Hr. Kalpa Sthana 14/29]
+
* Pranadharana-  sustain viatality [Arundatta A.Hr. [[Kalpa Sthana|Kalpa Sthana]] 14/29]
    
== Difference in Yapana and Anuvasana basti ==
 
== Difference in Yapana and Anuvasana basti ==
       +
{| class="wikitable"
 +
|+'''Table no.1: Difference in Yapana basti, Anuvasana Basti and Niruha Basti'''
 +
!'''Yapan basti'''
 +
!'''Anuvasana basti'''
 +
!'''Niruha basti'''
 +
|-
 +
|Mild (mrudu) in nature
 +
|It can be mild (mrudu) or sharp (tikshna) based on ingredients
 +
|Sharp (Tikshna) in nature
 +
|-
 +
|It leads to purification ([[Shodhana|shodhana]]) and nourishment ([[Brimhana|brimhana]]) at same time.
 +
|It mainly  leads to nourishment ([[Brimhana|brimhana]]).
 +
|Mainly for purification ([[Shodhana|shodhan]]) purpose.
 +
|-
 +
|[[Mamsa dhatu|Mamsa]], [[Asthi dhatu|asthi]] and [[Majja dhatu|majjagat dhatu]] related [[Vyadhi|diseases]] are treated by giving yapana basti
 +
|[[Vata dosha|Vata vyadhi]] and depletion related disorders (apatarpanottha roga) can be treated by  giving [[Anuvasana|anuvasana basti]]
 +
|[[Vata dosha|Vata vyadhi]]  and over nutrition related disorders (santarpanottha roga) are treated by giving [[Asthapana basti|niruha basti]]
 +
|-
 +
|Can be administered in healthy individual
 +
|Can be administered in healthy individual by less dose
 +
|Mostly can’t be given in healthy person
 +
|-
 +
|Single yapana basti is given
 +
|Combination with [[Asthapana basti|niruha]] gives more results
 +
|Always combine with [[Anuvasana|anuvasana]]
 +
|-
 +
|[[Basti|Basti]] retention time is more than [[Asthapana basti|niruha]]
 +
|[[Basti|Basti]] retention time is 3 hours
 +
|Retention time is 48 minutes
 +
|}
 +
{| class="wikitable"
 +
|+'''Ingredient described in different context:'''
 +
!'''Charak Samhita(12)'''
 +
!'''Sushrut Samhita(1)'''
 +
!'''Ashtang hruday(2)'''
 +
|-
 +
|Jaggery (guda)
 +
|Mustadi Rajyapan basti
    +
(su.chi.38/103)
 +
|Honey (Madhu)
 +
|-
 +
|[[Ghee|Ghee]] (ghrita)
 +
|Medicinal  decoction (mustadi kwath)
 +
|Oil (Tail)
 +
|-
 +
|Oil (taila), medicated paste (kalka)
 +
|Milk (ksheera)
 +
|Meat soup(mamsa rasa)
 +
|-
 +
|Honey (kshaudra)
 +
|Meat soup(mamsa rasa)
 +
|[[Ghee|Ghee]] (ajya)                                                        
 +
|-
 +
|Medicated milk
    +
(siddha ksheera)
 +
|Medicated paste (kalka)
 +
|Medicated paste (ghana kalka)
 +
|-
 +
|Meat soup (mamsa rasa)
 +
|
 +
|Musle fat (Vasa)(prasut)
 +
|-
 +
|Amlakanji (sour fermented liquid)
 +
|
 +
|
 +
|}
 +
{| class="wikitable"
 +
|+'''Pharmacological property of different ingredients of yapana basti:'''
 +
!'''Sr no'''
 +
!'''Contents'''
 +
!'''Sanskrit  name'''
 +
!'''Rasa'''
    +
'''(taste)'''
 +
!'''Veerya  (potency)'''
 +
!'''Vipaka'''
    +
'''(post  digestion effect)'''
 +
!'''Guna'''
    +
'''(properties)''' 
 +
!'''Chemical  constituents'''
 +
|-
 +
|1
 +
|Milk
 +
|Kshira
 +
|[[Madhura|Madhura (sweet)]]
 +
|[[Sheeta|Sheeta]]
    +
(cold)
 +
|[[Madhura|Madhura]]
    +
(sweet)
 +
|Snigdha (unctuous)
    +
Sara (moving)
 +
|Lactose
    +
Lipid
    +
Lieolinic acid
    +
Palmitic acid
 +
|-
 +
|2
 +
|Honey
 +
|Madhu
 +
|[[Madhura|Madhur]]
 +
 +
[[Kashaya|Kashay]]
 +
|[[Sheeta|Sheeta]]
 +
|[[Madhura|Madhura]]
 +
|[[Sheeta|Sheeta]],
 +
 +
Laghu,
 +
 +
Shukshma,
 +
 +
Vishada,
 +
 +
Ropana,
 +
|Glucose
 +
 +
Lactose
 +
 +
Vanallic acid
 +
 +
Pinobanksin
 +
 +
Galangin
 +
|-
 +
|3
 +
|Meat soup
 +
|[[Mamsa dhatu|Mamsa]]
 +
 +
rasa
 +
|[[Madhura|Madhura]]
 +
|
 +
|[[Madhura|Madhura]]
 +
|Guru
 +
|75% of water, 25%  of solids. Solids:
 +
 +
20% of proteins,  5% of organic substances
 +
|-
 +
|4
 +
|[[Ghee|Ghee]]
 +
|Ghruta
 +
|[[Madhura|Madhura]]
 +
|[[Sheeta|Sheet]]
 +
|[[Madhura|Madhura]]
 +
|Alpa
 +
 +
Abhishyandikari
 +
|Leonalic acid,
 +
 +
Beutenolic acid,
 +
 +
Lanosterol,
 +
|-
 +
|5
 +
|Rock salt
 +
|Saindhav
 +
|[[Lavana|Lavan]]
 +
|[[Sheeta|sheet]]
 +
|[[Madhura|madhur]]
 +
|Laghu
 +
 +
Snigdha
 +
 +
Sukshma
 +
|Nacl
 +
|-
 +
|6
 +
|Oil
 +
|Taila
 +
|As per its source
 +
|Ushna
 +
|As per its source
 +
|Tikshna,
 +
 +
Vyavayi,
 +
 +
Sukshma
 +
 +
 +
|Lipid
 +
 +
Folic acid, nicotinic  acid, planteose, pentosan
 +
|-
 +
|7
 +
|Jaggery
 +
|Guda
 +
|[[Madhura|Madhura]]
 +
|Ushna
 +
|[[Madhura|Madhur]]
 +
|Laghu,
 +
 +
Unabhishyandi
 +
|Sucrose
 +
 +
Fat
 +
 +
Protein
 +
 +
Ash
 +
|-
 +
|8
 +
|Fermented  alcohol based formulation
 +
|[[Amla|Amla]] kanji
 +
|[[Amla|Amla]]
 +
|ushna
 +
|[[Amla|Amla]]
 +
|Laghu,
 +
 +
Tikshna
 +
|Fermented  chemicals
 +
|}
 +
 +
== Indications ==
 +
<p style="text-align:justify;">Yapana basti is indicated for purification ([[Shodhana|shodhana]]), nourishment ([[Brimhana|brimhana]]) with  proper functioning of [[Vayu mahabhuta|vayu]] (vata anulomana). These are mridu basti. [Cha. Sa. [[Siddhi Sthana|Siddhi Sthana]] 12/29], hence these are indicated in [[Vyadhi|diseases]] due to [[Vata dosha|vata]] [[Pitta dosha|pitta]] vitiation and depletion of [[Shukra dhatu|shukra]] and [[Mamsa dhatu|mamsa dhatu]] (ksheena). <br/>It is indicated in following conditions: </p>
 +
<ol style="text-align:justify;"><li>Vishama [[Jwara Chikitsa|jvara]] [Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 3/302]<br/>
 +
Visham jwara is a condition where both [[Bala|strength (bala)]] of [[Dosha|dosha]] and [[Dhatu|dhatu]] are diminished. Hence these types of fevers come intermittently.</li>
 +
<li>Halimaka [Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 16/136]<br/>
 +
Halimaka is state where [[Vata dosha|vata]] and [[Pitta dosha|pitta]] are excessively increased and have excessive [[Bala|bala]] – shukra kshaya, redering the patient in very critical condition.</li>
 +
<li>Avrutta [[Vata dosha|vata]]  [Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 28/240]<br/>
 +
Long standing conditions of avrutta [[Vayu mahabhuta|vayu]] inevitabely lead to emaciation of [[Dhatu|dhatu]] ([[Shosha Nidana|shosha]]). Here yapan is used to increase [[Dhatu|dhatu]] as well as to achieve sroto [[Shodhana|shodhana]] and [[Vata dosha|vata]] anulomana.</li>
 +
<li>Jara sambhavaja klaibya  [Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 30/203]<br/>
 +
Jara is a condition where [[Rasa dhatu|rasa dhatu]] is unable to nourish all other [[Dhatu|dhatus]] </li>
 +
<li>Pain in lower half of [[Sharira|body]] <br/>
 +
It eradicates pain from rectum, thighs, knee joints, scrotum and bladder. (Payu janu uru vrushan basti shulnut) [Aas. Hru. [[Kalpa Sthana|Kalpa Sthana]] 4/29]</li></ol>
 +
Sushruta Samhita advise yapan basti in following condition: [Su.Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 38/111]
 +
<div style="column-count:2">
 +
# Vatrakta
 +
# Meha
 +
# [[Shvayathu Chikitsa|Shopha]]
 +
# [[Arsha Chikitsa|Arsha]]
 +
# [[Gulma Nidana|Gulma]]
 +
# Mutrakruchhha
 +
# Chakshushya
 +
# [[Visarpa Chikitsa|Visarp]]
 +
# [[Jwara|Jwara]]
 +
# [[Raktapitta|Raktapitta]]
 +
# Balya
 +
# Sanjeevan
 +
# Shoolanashak
 +
# Vrushya
 +
</div>
 +
 +
== Method of preparation ==
 +
<ol type="A" style="text-align:justify;"><li>Material required in making basti</li>
 +
<ul><li>Basti putak (enema bag)</li>
 +
<li>Basti netra (nozzle)</li>
 +
<li>Gloves</li>
 +
<li>Cotton cloth</li>
 +
<li>Mortal & pastel</li></ul>
 +
<li>Ingredients of [[Basti|basti]]</li>
 +
<ol><li>In case of yapana basti, medicated milk (sidhdha ksheera) is used in place of [[Kashaya|kashaya]] (decoction)</li>
 +
<li>Honey, mamsa rasa, [[Ghee|ghee]] are other major ingredients used in yapana basti.</li></ol>
 +
<li>Procedure to formulate & administration of basti:</li></ol>
 +
 +
=== Pre-procedure: ===
 +
<ol type="A" style="text-align:justify;"><li>Preparation of patient</li>
 +
<li>Preparation of [[Basti|basti]].</li></ol>
 +
<ol type="A" style="text-align:justify;"><li style="font-weight: bold;">Preparation of patient: <br/><span style="font-weight: normal;">After the evacuation of bladder and bowels, local massage and fomentation on pelvic region shall be done.</span></li>
 +
<li style="font-weight: bold;">Preparation of basti:<br/><span style="font-weight: normal;">First of all, the dravyas soaked in warm water for overnight then next morning milk and water should be added with the measurement 1:8:16 and kept for boiling upto ashtamansh shoshit (..).
 +
<br/>This siddha ksheera is kept nearby. Then take morter and pestle and add [[Lavana|lavan]] and triturate it properly then add makshik followed by sneh (ghrut/tail/vasa) followed by kalka (various aushadhi) and then sidhdh ksheera. Make homogenous mixture of it by continuous stirring of morter within pestle. The proportion of [[Dravya|dravyas]] are as per classical list.
 +
</span></li></ol>
 +
 +
=== Main procedure (pradhana karma) and  post procedure (pashchat karma): ===
 +
<p style="text-align:justify;">The procedure for administration of yapana basti and post therapeutic protocol are same as like therapeutic enema ([[Basti|basti]]).
 +
<br/>Some clinical research suggests that average retention time of yapan basti is 92 minutes.(Gajanan Kulkarni) </p>
 +
 +
=== Adverse effect and it’s management: ===
 +
<p style="text-align:justify;">The improper administration of yapana basti can lead to following adverse effects like oedema, loss of digestive power, anemia, pain, hemorrhoids, proctalgia/fissure in ano, fever, diarrhea.
 +
<br/>In such cases, patients are treated with medicinal formulations like [[Arishta|arishta]], kshira, [[Sidhu|sidhu]]. All the treatment planned should be aimed at increasing the power of digestion. [Cha.Sa. [[Siddhi Sthana|Siddhi Sthana]] 2/31]
 +
<br/>Sometime due to its mild nature (mrudutva), the yapana basti does not get eliminated out of [[Sharira|body]]. Then immediately another asthapana basti with cow urine (gomutra) and other sharply acting agents (tikshna dravyas) should be administered.</p>
 +
 +
=== Time of administration ===
 +
Yapana basti can be given at all times and after meal also.
 +
 +
== Practical application and rationale behind using of yapana basti ==
 +
<p style="text-align:justify;">Among all these [[Vyadhi|diseases]] which are mentined above, there is obvious loss of one or more components ([[Dhatu|dhatu]]) of the [[Sharira|body]]. Moreover, all these dieases are chronic in nature.
 +
<br/>The following phenomena appear in this type of [[Vyadhi|diseases]] due to the damage to [[Sharira|body]] components that has already taken place (dhatukshaya) and prolonged presence of the [[Vyadhi|disease]] in the [[Sharira|body]].</p>
 +
<ol style="text-align:justify;"><li>[[Vata dosha|Vata dosha]] rages very strongly (vayurdhatukshayatkopo). This overpowered vayu carries [[Pitta dosha|pitta]] and [[Kapha dosha|kapha dosha]] to different parts of [[Sharira|body]] [Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 28/60] and gets obstructed by them. Once it gets obstructed there, [[Vayu mahabhuta|vayu]] starts absorbing and emaciating the [[Dhatu|dhatu]] present there. [Cha.Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 28/61]
 +
<br/>This extension in the pathology of original [[Vyadhi|disease]] gives rise to more depletion of [[Dhatu|dhatu]] (dhatu kshaya) and causing new symptoms or [[Vyadhi|disease]].
 +
<br/>It means that the original [[Vyadhi|disease]] becomes more serious. If we look at these [[Vyadhi|diseases]] like halimaka, vishama [[Jwara Chikitsa|jvara]] etc., these all are fatal in nature, because such type of extended pathophysiology.</li>
 +
<li>Prolonged [[Vyadhi|disease]] condition with extension of [[Dosha|dosha]] in all over [[Sharira|body]] involves all other systems in [[Sharira|body]] in [[Vyadhi|disease]] process. This makes the original [[Vyadhi|disease]] multisystemic disorder, and this can cause critical condition of the patient. </li>
 +
<li>From the discussion, so far it is clear that the following things happen in all of the above mentioned [[Vyadhi|diseases]] :</li>
 +
<ol type="a"><li>Great loss of [[Sharira|body]] components in a progressive way</li>
 +
<li>Very strong dominance of [[Vata dosha|vata]] in pathogenesis due to dhatukshaya and [[Avarana|avarana]] as well.</li>
 +
<li>Multi system involvement</li>
 +
<li>A huge fall in strength of [[Sharira|body]]. (balaadhishthanam aarogyam) [Cha.Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 3]</li></ol></ol>
 +
<p style="text-align:justify;">Now considering the treatment of these conditions, there needs to be a treatment that has, nourishment ([[Brimhana|brimhana]]), strengthening power (balya), pacifying [[Vayu mahabhuta|vayu]] ([[Vata dosha|vata]] [[Shamana|shamana]]), anulomana and clearing the channels (srotoshodhan) property.
 +
<br/>Yapan basti hits all these criteria to treat these ailments surely.
 +
<br/>This clearing of channels (srotoshodhana), provides lubrication ([[Snehana (unction therapy)|snehana]]), [[Vata dosha|vata]] anulomana, nourishment ([[Brimhana|brimhana]]) and strengthening power (balya). Yapan basti becomes a radical therapy there.</p>
 +
 +
== Things to be avoided during yapan basti therapy ==
 +
Vyayama – exercise
 +
<br/>Maithuna – sexual activities       
 +
<br/>Madya – alcoholic beverages
 +
<br/>Madhu – honey
 +
<br/>Shishira ambu –Intake of cold water
 +
<br/>Rath kshobha – travelling 
 +
 +
== Current researches ==
 +
=== Effect of yapana basti in shukragata vata ===
 +
<p style="text-align:justify;">In a clinical study, the effect of yapana basti and akarakarabhadi yoga was assessed in cases of shukragata vata. The patients treated with protocol of yapana basti and akarkarbhadi yoga showed considerable improvement (55.35%) in premature ejaculation.<ref name="ref1">Mangalasseri Prakash (2002): A clinical study of shukragata-vata w.s.r. to premature ejaculation and its management with akarakarabhadi yoga and yapana basti, Department of Kayachikitsa, IPGT &RA, Jamnagar.</ref></p>
 +
 +
=== Effect of yapana basti in shukra dushti ===
 +
<p style="text-align:justify;">In a clinical study, the effect of yapana basti was assessed in case of shukra dushti. The patient treated with protocol of yapana basti and [[Vajikarana|vajikarana]] yoga showed considerable improvement in semen volume (32%), sperm viability(14.6%) and sperm count(42.58%).<ref name="ref2">Gupta, S.K., Prasad, N.K., Shukla, V.D., & Thakar, A. (2016). Effect of Baladi Yapana Basti and Vajikarana Yoga in the management of Oligoasthenozoospermia. Department of Panchakarma, IPGT &RA, Jamnagar.</ref></p>
 +
 +
=== Effect of yapana basti in pakshaghata ===
 +
<p style="text-align:justify;">In clinical study, the effect of yapana basti was assessed in case of pakshaghata. The patient treated with protocol of yapan basti and karm basti showed considerable improvement in  speech (100%), facial expression (44.44%), and drooping wrist (21.42%).<ref name="ref3">Gajanana Kulkarni.(2007). A Comparative Study of Role Of Yapana Basti And Karma Basti In The Management Of Pakshaghata (CVA). Department of Panchakarma, IPGT &RA, Jamnagar.</ref></p>
 +
 +
=== Effect of yapana basti in kampavata ===
 +
<p style="text-align:justify;">In a clinical study, the effect of yapana basti was assessed in case of kampavata. The patient treated with protocol of yapan basti showed considerable improvement in kampa (tremors) (41.17%), [[Stambhana|stambha]] (stiffness) (46.15%),  in gati vikriti (movements) (60%), in vak vikriti (abnormal speech)(50%)  and [[Smruti (memory)|smriti (memory)]](33.33%). <ref name="ref4">Vinay Chaudhary. (2007) Clinical Study Of Standardization Of Yapan Basti In The Management Of Kampavata. Department of Panchakarma, IPGT &RA, Jamnagar.</ref></p>
 +
 +
=== Effect of yapana basti in katigraha ===
 +
<p style="text-align:justify;">In a clinical study, the effect of yapana basti was assessed to study its efficacy in katigraha (lumbago with stiffness). The patient treated with protocol of erandmuladi yapana basti and erandabeeja kshirapaka showed considerable improvement in katigraha (lumbago with stiffness) (70%), kati shula (pain in waist) (70.97%), sparsha asahatwa (tenderness) (91.11%).<ref name="ref5">Damayanthie Fernando KP, Thakar AB, Shukla VD. Clinical efficacy of Eranda Muladi Yapana Basti in the management of Kati Graha (Lumbar spondylosis). Ayu. 2013 Jan;34(1):36-41. doi: 10.4103/0974-8520.115444. PMID: 24049403; PMCID: PMC3764877</ref></p>
 +
 +
=== Effect of yapana basti in cervical spondylosis ===
 +
<p style="text-align:justify;">In a clinical study, the effect of yapana basti was assessed in case of cervical spondylosis. The patient treated with protocol of bruhatyadi yapan basti and patrapinda sweda showed considerable improvement in spine, like flexion (81.82%), extension (67.74%), lateral rotation (82.93%), numbness (91.30%), tingling sensation (80.95%).<ref name="ref6">Rani Sangeeta Ishwar Singh, A Randomized Clinical Trial On Brihatyadi Yapana Basti And Patra Pinda Sweda With Aaditya Paka Guggulu In The Management Of Cervical Spondylosis W.S.R. To Asthigata Vata
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https://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=13976&EncHid=&modid=&compid=%27,%2713976det%27
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</ref></p>
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=== Effect of yapana basti in vandhyatva (infertility) ===
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<p style="text-align:justify;">In a clinical study, the effect of yapana basti was assessed in cases of vandhyatva. The patient treated with protocol of brihtyadi yapana basti and shivalingi beej churna showed considerable improvement in effect on ovulation (80%) and follicular size.<ref name="ref7">Balat, Gaurav et al. “Effect of Brihatyadi Yapana Basti and Shivalingi (Bryonia laciniosa Linn.) seed powder in the management of female infertility (Vandhyatva) due to anovulatory factor: An open-labelled randomized clinical trial.” Ayu vol. 40,4 (2019): 216-222. doi:10.4103/ayu.AYU_123_18
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https://pubmed.ncbi.nlm.nih.gov/33935438/
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</ref></p>
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These preliminary studies show positive effects of yapana basti in various conditions. More focused research can be helpful in understanding effect of yapana basti in chronic and critical conditions.
    
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